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Safety, efficacy and refractive outcomes of LASIK surgery in patients aged 65 or older

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Abstract

Purpose

Report on the safety, efficiency and refractive outcomes of LASIK surgery in patients aged 65 or older.

Methods

This study includes a case series of patients ≥65 years that underwent corneal refractive surgery during the period June 2010 to June 2015 at Hospital Zambrano Hellion, Monterrey, Mexico. Inclusion criteria were normal topography, central corneal thickness >500 μm, preoperative manifest refraction spherical equivalent (MRSE) up to −8.5 D and +6.0 D, cylinder up to −6.0 D, CDVA of 20/25 or better and with no other ocular pathology.

Results

A total of 44 eyes (24 patients) were included. Mean age was 67.2 ± 2.1 years (range 65–80), with mean follow-up of 12.2 ± 1.3 months. Conventional LASIK was performed in 20 patients (group 1, 36 eyes) to improve UDVA (10 eyes myopic LASIK and 26 eyes hyperopic LASIK) and presbyopic LASIK (monovision) in 4 patients (group 2, 8 eyes) to restore near-vision performance. Preoperative MRSE group 1 was myopic: −2.79 ± 1.88 D; hyperopic +2.19 ± 1.88 D; and +2.10 ± 0.87 D in group 2. Preoperative UDVA in group 1 was 0.67 ± 0.30 LogMAR; 0.46 ± 0.18 LogMAR; and Jaeger ≥4 in 90% in group 2. Postoperative MRSE: −0.29 ± 0.86 D (myopic LASIK) (p < 0.001), +0.34 ± 0.62 D (hyperopic LASIK) (p < 0.001) and −1.25 ± 0.59 D (non-dominant eye) in presbyopic LASIK. Postoperative UDVA in myopic LASIK was 0.15 ± 0.30 (p = 0.001) and 0.11 ± 0.11 (p < 0.001) for hyperopic LASIK. In group 2, binocular UDVA was 0.16 ± 0.17 (p = 0.12) and UNVA was ≥J2 in 100% of the patients.

Conclusion

Even though elder patients may present greater LASIK restrictions due to lens and other ocular age-related changes, patients ≥65 years that were candidates for conventional and presbyopic LASIK showed satisfactory and safe refractive and visual outcomes.

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References

  1. Christensen K, Doblhammer G, Rau R, Vaupel J (2009) Ageing populations: the challenges ahead. Lancet 374(9696):1196–1208. doi:10.1016/s0140-6736(09)61460-4

    Article  PubMed  PubMed Central  Google Scholar 

  2. Cartel TL (1994) Age-related vision changes: a primary care guide. Geriatrics 49(9):37–42

    Google Scholar 

  3. Loh KY, Ogle J (2004) Age related visual impairment in the elderly. Med J Malaysia 59(4):562–568

    PubMed  CAS  Google Scholar 

  4. Bengtsson B, Grodum K (1999) Refractive changes in the elderly. Acta Ophthalmol Scand 77(1):37–39. doi:10.1034/j.1600-0420.1999.770109.x

    Article  PubMed  CAS  Google Scholar 

  5. Rosen E, Alió JL, Dick HB, Dell S, Slade S (2016) Efficacy and safety of multifocal intraocular lenses following cataract and refractive lens exchange: metaanalysis of peer-reviewed publications. J Cataract Refract Surg 42(2):310–328. doi:10.1016/j.jcrs.2016.01.014

    Article  PubMed  Google Scholar 

  6. Jain S, Ou R, Azar DT (2001) Monovision outcomes in presbyopic individuals after refractive surgery. Ophthalmology 108:1430–1433. doi:10.1016/s0161-6420(01)00647-9

    Article  PubMed  CAS  Google Scholar 

  7. Miranda D, Krueger RR (2004) Monovision laser in situ keratomileusis for pre-presbyopic and presbyopic patients. J Refract Surg 20(4):325–328

    PubMed  Google Scholar 

  8. Roudakova TE, Kourenkov VV, Polounine GS (2000) Planned undercorrection with laser in situ keratomileusis and photorefractive keratectomy for myopes over age 40. J Refract Surg 16(2 Suppl):S261–S263. doi:10.3928/1081-597X-20000302-14

    Article  PubMed  CAS  Google Scholar 

  9. López-Montemayor P, Hernández-Camarena J, Valdez-García J (2015) Patient profile and postoperative follow up compliance in refractive surgery. Rev Mex Oftalmol 90(3):125–128. doi:10.1016/j.mexoft.2015.08.001

    Article  Google Scholar 

  10. Behrens A, Doyle JJ, Stern L, Chuck RS, McDonnell PJ, Azar DT et al (2006) Dysfunctional tear syndrome: a Delphi approach to treatment recommendations. Cornea 25(8):900–907

    Article  PubMed  Google Scholar 

  11. Feltham MH, Wong R, Wolfe R, Stapleton F (2008) Variables affecting refractive outcome following LASIK for myopia. Eye 22(9):1117–1123. doi:10.1038/sj.eye.6702856

    Article  PubMed  CAS  Google Scholar 

  12. Roth HL, Lora AN, Heilman KM (2002) Effects of monocular viewing and eye dominance on spatial attention. Brain 125(Pt 9):2023–2035. doi:10.1093/brain/awf210)

    Article  PubMed  Google Scholar 

  13. Solomon KD, Fernández de Castro LE, Sandoval HP, Biber JM, Groat B, Neff KD, Ying MS et al (2009) LASIK world literature review: quality of life and patient satisfaction. Ophthalmology 116:691–701. doi:10.1016/j.ophtha.2008.12.037

    Article  PubMed  Google Scholar 

  14. Levinger E, Levinger E, Trivizki O, Pokroy R, Levartovsky S, Sholohov G, Levinger S (2013) Monovision surgery in myopic presbyopes: visual function and satisfaction. Optom Vis Sci 90(10):1092–1097. doi:10.1097/OPX.0000000000000002

    Article  PubMed  Google Scholar 

  15. Schallhorn SC, Venter JA, Teenan D, Hannan SJ, Hettinger KA, Pelouskova M, Schallhorn JM (2016) Patient-reported outcomes 5 years after laser in situ keratomileusis. J Cataract Refract Surg 42(6):879–889. doi:10.1016/j.jcrs.2016.03.032

    Article  PubMed  Google Scholar 

  16. Ghanem R, de la Cruz J, Tobaigy F, Ang L, Azar D (2007) LASIK in the presbyopic age group—safety, efficacy, and predictability in 40- to 69-year-old patients. Ophthalmology 114(7):1303–1310. doi:10.1016/j.ophtha.2006.10.026

    Article  PubMed  Google Scholar 

  17. Bragheeth MA, Fares U, Dua HS (2008) Re-treatment after laser in situ keratomileusis for correction of myopia and myopic astigmatism. Br J Ophthalmol 92:1506–1510. doi:10.1136/bjo.2008.143636

    Article  PubMed  CAS  Google Scholar 

  18. Sutton G, Lawless M, Hodge C (2013) Laser in situ keratomileusis in 2012: a review. Clin Exp Optom 97(1):18–29. doi:10.1111/cxo.12075

    Article  PubMed  Google Scholar 

  19. Kim P, Briganti EM, Sutton GL, Lawless MA, Rogers CM, Hodge C (2005) Laser in situ keratomileusis for refractive error after cataract surgery. J Cataract Refract Surg 31:979–986. doi:10.1016/j.jcrs.2004.08.054

    Article  PubMed  Google Scholar 

  20. Fotedar R, Mitchell P, Burlutsky G, Wang JJ (2008) Relationship of 10-year change in refraction to nuclear cataract and axial length findings from an older population. Ophthalmology 115(8):1273–1278. doi:10.1016/j.ophtha.2007.11.003 (1278.e1)

    Article  PubMed  Google Scholar 

  21. Hyman L (2007) Myopic and hyperopic refractive error in adults: an overview. Ophthalmic Epidemiol 14(4):192–197

    Article  PubMed  Google Scholar 

  22. Lee KE, Klein BE, Klein R, Wong TY (2002) Changes in refraction over 10 years in an adult population: the Beaver Dam Eye study. Invest Ophthalmol Vis Sci 43(8):2566–2571

    PubMed  Google Scholar 

  23. Marcos S (2002) Are changes in ocular aberrations with age a significant problem for refractive surgery? J Refract Surg 18(5):S572–S578

    PubMed  Google Scholar 

  24. Xie W (2016) Recent advances in laser in situ keratomileusis-associated dry eye. Clin Exp Optom 99(2):107–112. doi:10.1111/cxo.12361

    Article  PubMed  Google Scholar 

  25. Chao C, Golebiowski B, Stapleton F (2014) The role of corneal innervation in LASIK-induced neuropathic dry eye. Ocul Surf 12(1):32–45. doi:10.1016/j.jtos.2013.09.001

    Article  PubMed  Google Scholar 

  26. Mashaghi A, Hong J, Chauhan SK, Dana R (2017) Ageing and ocular surface immunity. Br J Ophthalmol 101(1):1–5. doi:10.1136/bjophthalmol-2015-307848

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Servicio de Córnea y Cirugía Refractiva, Instituto de Oftalmología y Ciencias Visuales, Escuela de Medicina, Tecnológico de Monterrey, Monterrey, Mexico

    Paloma López-Montemayor, Jorge E. Valdez-García, Denise Loya-García & Julio C. Hernandez-Camarena

  2. Instituto de Oftalmología y Ciencias Visuales, Centro Medico Zambrano Hellion, Batallón de San Patricio 112, Piso 1 Ote, C.P. 66278, San Pedro Garza García, Nuevo Leon, Mexico

    Julio C. Hernandez-Camarena

Authors
  1. Paloma López-Montemayor
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  2. Jorge E. Valdez-García
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  3. Denise Loya-García
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  4. Julio C. Hernandez-Camarena
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Corresponding author

Correspondence to Julio C. Hernandez-Camarena.

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López-Montemayor, P., Valdez-García, J.E., Loya-García, D. et al. Safety, efficacy and refractive outcomes of LASIK surgery in patients aged 65 or older. Int Ophthalmol 38, 1515–1520 (2018). https://doi.org/10.1007/s10792-017-0614-3

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  • DOI: https://doi.org/10.1007/s10792-017-0614-3

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